https://orcid.org/0000-0002-7767-0825
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Abstract
Background
Chronic low back pain (CLBP) is a highly prevalent condition among adults and is correlated to high levels of pain, high disability, and lower quality of life. Pain neuroscience education (PNE) helps to explain the pain experience and can affect psychosocial factors, such as fear of movement, anxiety, socioeconomic status, work life satisfaction, etc. More recently, virtual reality (VR) programs have emerged allowing for immersive PNE experiences.
Objective
The purpose of this randomized clinical trial is to determine the feasibility of using a VR application for the delivery of immersive PNE (VR-PNE) and other activity training for patients with CLBP presenting to outpatient physical therapy (PT) clinics.
Methods
A two-arm, parallel group, randomized controlled feasibility trial of patients was conducted at 12 outpatient PT clinics from March 9, 2022, through September 9, 2022. The intervention group received PT as usual and VR-PNE while the control group received PT as usual. Between group feasibility, acceptability outcomes and other patient-reported outcomes were assessed at six weeks.
Results:
A total of 595 individuals were evaluated for low back pain during the recruitment period. Seventy individuals were eligible and met definition for CLBP, 52 enrolled and 32 completed the trial. Participant adherence was 63.6% for VR-PNE and 63.2% for PT as usual. Participants found VR-PNE acceptable and reported satisfaction scores (0–100) of 87.37 ± 11.05 compared to 81.17 ± 23.72 in the PT as usual group. There were no significant differences between groups for the BBQ, BRS, FABQ-PA, FABQ-W, GROC, NPRS, NPQ, PCS, and PSEQ at 6 weeks.
Conclusion
The results of the trial suggest that VR-PNE may be acceptable and feasible for patients with CLBP. Study procedures and PT delivery modifications should be considered for the next iteration of this study to improve follow-up assessment rates.
Acknowledgements
The authors wish to thank the physical therapists that participated in this study (Alex Crabill, Emily Cobb, Paul Mittura, Mitchell Silvers, Taylor Grantham, Clay McClain, Derik Elmore, Beth Atchley, Kim Sauers, Heather Netherly, Ashley Sager, Joseph Fowler, Jonathan Brown, Rob Colasso, Lauren West).
Authors contributions
RM and EL conceived the broader study idea. RM, EL, GW, DL, and HG were involved with the design. RM, EL, JF were involved with analysis and interpretation of data. All authors were involved in drafting of the paper and revising it critically for intellectual content, approval of final version of the manuscript, and all agree to be accountable for all aspects of the work.
Disclosure statement
The authors report that there are no competing interests to declare.
Data availability
The data that support the findings of this study are available from the corresponding author, [RM], upon reasonable request.